Florida Medicaid does cover dental services, but the extent of coverage can vary based on factors such as age, specific Medicaid program, and the type of dental service needed.
Medicaid in Florida generally covers dental services for children under 21, including exams, cleanings, fluoride treatments, fillings, and crowns.
However, adults have more limited coverage, which may include exams, cleanings, X-rays, but not necessarily root canals, extractions, or dentures without prior authorization.
It’s crucial to directly contact Florida Medicaid or your Managed Care plan to understand coverage.
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Dental Care: Why It’s Important
Seeing a dentist at least twice a year is crucial for babies, children, and adults.
The earlier children start seeing a dentist, the healthier their gums and teeth will remain throughout their lives.
It’s recommended that children begin dental check-ups by age 1, even before they have teeth.
Regular dental visits and early intervention can prevent issues with teeth and gums.
Maintaining good oral hygiene through practices like brushing, flossing, and avoiding sugary foods and drinks contributes to healthy teeth and gums.
Neglecting tooth problems can lead to significant impacts on overall health.
Tooth issues can result in difficulties with biting and chewing food, academic challenges, or absences from school due to pain.
Additionally, poor dental health can affect speech.
Dental Care for Children Ages 0-20: What Florida Medicaid Does Cover
Florida Medicaid aims to ensure children’s health by providing a range of dental services at no cost.
The following list outlines the services available to promote healthy teeth in children:
- Teeth Cleanings
- Fluoride Treatment
- Sealants
- Oral Health Instructions
- Space Maintainers
- Periodontics
- Prosthodontics
- Orthodontics
- Extractions
- Sedation
- Dental Exams
- Fillings and Crowns
- Root Canals
- Ambulatory Surgical Center or Hospital-based Dental Service
Certain services may necessitate prior permission from a dental plan, known as prior authorization before the dentist can proceed.
Dental plans will cover services deemed medically necessary.
Dental Care for Adults Ages 21 and Up: What Florida Medicaid Covers
The dental plans starting December 1, 2018, cover emergency-based dental services as follows:
- Limited Dental Exams
- Limited Dental X-rays
- Extractions
- Dentures
- Pain management
- Sedation
- Problem-focused treatments
Recipients aged 21 or older may qualify for additional dental services.
Pregnant women aged 21 and older may have access to more services to support a healthy pregnancy.
These expanded benefits are additional goods or services provided by dental plans to adult and pregnant adult recipients at no cost:
- Additional dental exams
- Additional extractions
- Dental consultations
- Additional dental X-rays
- Dental screenings
- Fluoride Sealants
- Oral Health Instructions
- Teeth Cleanings (basic and deep)
- Fillings (silver and white)
- Dental office diabetic testing
- A visit to the dental office for individuals with disabilities to become familiar with the office and dentist before dental work is performed.
Who pays for Florida Medicaid Dental Services?
Starting December 1, 2018, dental services are covered by Florida Medicaid dental plans.
You can find a dental plan by visiting the website www.flmedicaidmanagedcare.com
or call 1-877-711-3662 to talk to a Florida Medicaid Choice Counselor.
Find a Florida Medicaid Dentist
Florida Medicaid dental plans will assist children and adults in finding a dentist and a dental home.
You can call a dental plan for help.
The Member Services Department of each dental plan can answer questions.
The dental plans will assist in choosing or changing dentists, determining coverage for services, providing referrals, locating a provider, replacing a lost ID card, and explaining any changes that may impact dental benefits.
Transportation to the Dentist
Your Medicaid health plan arranges transportation to a dentist appointment if needed.
If you require a ride, ask your health plan for assistance.
Conclusion
Florida Medicaid covers dental services, but the extent of coverage can vary based on factors such as age, eligibility category, and specific dental needs.
Individuals should check with their Medicaid plan or provider to understand the scope of dental services covered under their plan.